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General NPI Number Information
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NPI Number | 1699943993
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Entity Type | Organization
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Legal Business Name | VETERAN'S AFFAIRS HOSPITAL
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Dates
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Enumeration Date | 02/20/2008
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Last Update Date | 02/20/2008
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Provider Practice Location Address
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Address Line | 10711 105TH STREET CT SW
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City | TACOMA
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State | WA
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Zip | 98498-1553
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Country | US
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Telephone | 253-583-1124
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Fax |
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Provider Business Mailing Address
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Address Line | 10711 105TH STREET CT SW
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City | TACOMA
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State | WA
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Zip | 98498-1553
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | MS. PAMELA JEAN GRAY
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Credential | BSN
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Telephone | 253-583-1124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | RN00156340
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License Number State | WA
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